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南佛罗里达浸信会健康中心的迈阿密心脏研究(MiHeart):一项针对无症状年轻和中年成年人亚临床心血管疾病及新出现的心血管危险因素的前瞻性研究:迈阿密心脏研究:原理与设计。

The Miami Heart Study (MiHeart) at Baptist Health South Florida, A prospective study of subclinical cardiovascular disease and emerging cardiovascular risk factors in asymptomatic young and middle-aged adults: The Miami Heart Study: Rationale and Design.

作者信息

Nasir Khurram, Ziffer Jack A, Cainzos-Achirica Miguel, Ali Shozab S, Feldman David I, Arias Lara, Saxena Anshul, Feldman Theodore, Cury Ricardo, Budoff Matthew J, Fialkow Jonathan

机构信息

Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA.

Center for Outcomes Research, Houston Methodist Hospital, Houston, TX, USA.

出版信息

Am J Prev Cardiol. 2021 May 28;7:100202. doi: 10.1016/j.ajpc.2021.100202. eCollection 2021 Sep.

Abstract

OBJECTIVE

The Miami Heart Study (MiHeart) at Baptist Health South Florida is an ongoing, community-based, prospective cohort study aimed at characterizing the prevalence, characteristics, and prognostic value of diverse markers of early subclinical coronary atherosclerosis and of various potential demographic, psychosocial, and metabolic risk factors. We present the study objectives, detailed research methods, and preliminary baseline results of MiHeart.

METHODS

MiHeart enrolled 2,459 middle-aged male and female participants from the general population of the Greater Miami Area. Enrollment occurred between May 2015 and September 2018 and was restricted to participants aged 40-65 years free of clinical cardiovascular disease (CVD). The baseline examination included assessment of demographics, lifestyles, medical history, and a detailed evaluation of psychosocial characteristics; a comprehensive physical exam; measurement of multiple blood biomarkers including measures of inflammation, advanced lipid testing, and genomics; assessment of subclinical coronary atherosclerotic plaque and vascular function using coronary computed tomography angiography, the coronary artery calcium score, carotid intima-media thickness, pulse wave velocity, and peripheral arterial tonometry; and other tests including 12-lead electrocardiography and assessment of pulmonary function. Blood samples were biobanked to facilitate future ancillary research.

RESULTS

MiHeart enrolled 1,261 men (51.3%) and 1,198 women (48.7%). Mean age was 53 years, 85.6% participants were White and 47.4% were of Hispanic/Latino ethnicity. The study included 7% individuals with diabetes, 33% with hypertension, and 15% used statin therapy at baseline. Overweight or obese participants comprised 72% of the population and 3% were smokers. Median 10-year estimated atherosclerotic CVD risk using the Pooled Cohort Equations was 4%.

CONCLUSION

MiHeart will provide important, novel insights into the pathophysiology of early subclinical atherosclerosis and further our understanding of its role in the genesis of clinical CVD. The study findings will have important implications, further refining current cardiovascular prevention paradigms and risk assessment and management approaches moving forward.

摘要

目的

南佛罗里达浸信会健康中心的迈阿密心脏研究(MiHeart)是一项正在进行的、基于社区的前瞻性队列研究,旨在描述早期亚临床冠状动脉粥样硬化的各种标志物以及各种潜在的人口统计学、心理社会和代谢风险因素的患病率、特征和预后价值。我们介绍了MiHeart的研究目标、详细研究方法和初步基线结果。

方法

MiHeart从大迈阿密地区的普通人群中招募了2459名中年男性和女性参与者。招募时间为2015年5月至2018年9月,仅限于年龄在40 - 65岁且无临床心血管疾病(CVD)的参与者。基线检查包括人口统计学、生活方式、病史评估以及心理社会特征的详细评估;全面的体格检查;多种血液生物标志物的测量,包括炎症指标、高级血脂检测和基因组学检测;使用冠状动脉计算机断层扫描血管造影、冠状动脉钙化评分、颈动脉内膜中层厚度、脉搏波速度和外周动脉张力测量法评估亚临床冠状动脉粥样硬化斑块和血管功能;以及其他检查,包括12导联心电图和肺功能评估。采集血液样本进行生物样本库储存,以方便未来的辅助研究。

结果

MiHeart招募了1261名男性(51.3%)和1198名女性(48.7%)。平均年龄为53岁,85.6%的参与者为白人,47.4%为西班牙裔/拉丁裔。该研究包括7%的糖尿病患者、33%的高血压患者,且15%的参与者在基线时使用他汀类药物治疗。超重或肥胖参与者占总人群的72%,3%为吸烟者。使用合并队列方程估计的10年动脉粥样硬化性CVD风险中位数为4%。

结论

MiHeart将为早期亚临床动脉粥样硬化的病理生理学提供重要的新见解,并加深我们对其在临床CVD发生中作用的理解。研究结果将具有重要意义,进一步完善当前的心血管预防模式以及未来的风险评估和管理方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f21f/8387278/46803c327e50/gr1.jpg

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